Analgesia

Analgesia is the relief of pain without loss of consciousness. It encompasses pharmacologic and nonpharmacologic strategies intended to reduce pain and improve function while minimizing harm. It is distinct from anesthesia, which involves loss of sensation and often consciousness.

Pain can be nociceptive (somatic or visceral), neuropathic, or mixed. Analgesic approaches include systemic medications (oral or intravenous), regional or local techniques (nerve blocks, epidurals), topical treatments, and nonpharmacologic methods such as physical therapy, cognitive behavioral therapy, and heat or cold.

Non-opioid analgesics such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for mild to moderate pain and inflammation. Opioid analgesics (for example, morphine, oxycodone) are effective for moderate to severe pain but carry risks of respiratory depression, sedation, constipation, and potential misuse. Monitoring and proper dosing are essential.

Adjuvant analgesics—antidepressants, anticonvulsants, corticosteroids, and certain local anesthetics—are used particularly for neuropathic or inflammatory pain. Regional methods, including nerve blocks and neuraxial techniques, provide targeted relief and can reduce systemic drug exposure.

Pain assessment using standardized scales guides analgesia. A multimodal, individualized plan—often employing the lowest effective doses of multiple agents—reduces adverse effects. Special populations (pregnant individuals, older adults, those with kidney or liver disease) require tailored choices.